Open Forum: Mental health patients deserve choice over where they are treated

Compulsory treatment in the community as the Mental Health Bill proposes might, where possible, initially seem a good idea. The patient may have a sense of attachment to the homely environment and can spend more time with friends and family. It also mitigates the stigma of having a relative who is “sectioned” and taken off for long periods to the “loony bin”.

But others will be sceptical and view compulsory community treatment as a way of saving money in a manner which could put people’s lives at risk. It may be that mistakes are made and that without constant monitoring the patient may commit suicide. In my own experience symptoms can worsen quite suddenly.

Some people I know think they would get more medical attention by going to hospital, where medical staff have more time to observe symptoms and the day-to-day effects of trying one medication after another. The question “how well have you been?” is not a pressure that should be put on the patient or their family.

Again, the onus is being put on the family in another way. They have to help their relatives and watch them suffer. There is the likely impact on younger family members where they will not fully understand the concept of mental illness but are going to know that there is something seriously wrong with their loved one. In extreme cases, children can be removed by social services.

The psychiatrist RD Laing actually thought the family could be the cause of schizophrenia. Where children are batted like a ping pong ball between arguing parents they escape off into a fantasy realm of schizophrenia. So hospital could be an escape from a damaging home environment.

An answer may be to give patients a choice between treatment in a hospital or at home. Family life is as we know not all it should be. The sociologist Edward Leach described it as an “overloaded circuit” in which “huddled together in their loneliness the parents fight and the children rebel.” The home environment may offer little in the way of therapy.